How a Fictional Medical Drama Tackled a Real Pandemic

Casualty, a beloved BBC TV show, has had to make some major adjustments because of COVID-19.

A smiling white woman with glasses and curly hair.
Jenny Thompson. Courtesy of Jenny Thompson

On this week’s episode of Working, June Thomas spoke with Jenny Thompson about her role as the story producer for the BBC medical drama Casualty. They discussed what it’s like to work on a show that’s been on the air for more than 30 years, how she plans out the different storylines for each season, and how her team makes sure the episodes are medically accurate. This partial transcript has been edited and condensed for clarity.

June Thomas: I would say the biggest difference between a British medical show and an American medical show is the National Health Service. The NHS isn’t just a health care delivery system. It’s also a beloved British institution, and an institution that people have a lot of feelings about, to the extent that it was the centerpiece of the opening ceremony of the London Olympics eight years ago. How does that affect your job?

Jenny Thompson: I think it’s the best place that you could set drama. Not just because it’s an emergency department, but because it is this institution that is loved, that sometimes disappoints us, but also seems to always be there for us. I think that there’s a deep love for, but also sometimes an ambivalence about, the NHS in the U.K. that our regular characters—people who work for the NHS—can really feel and encapsulate. They can be annoyed about low pay. They can be annoyed about bureaucracy. They can be annoyed that they have these targets that are set by the government.

There’s something in that which really resonates with people, because I think every person in Britain has probably had an interaction with the NHS that has been frustrating. But, at the same time, I was born in an NHS hospital, so were my parents, so were my grandparents. You wouldn’t be without it. That’s a huge part of the show. The fact that anyone can walk through the door and will be helped.

Let’s talk about the impact of COVID-19. What’s it been like? Casualty has been off the air for several months. In the episodes that did air after the pandemic began, a very realistic show has been not realistic because it hasn’t been referring to COVID, which didn’t exist when those episodes were written and made. I’m sure it is also causing huge challenges for planning.

It’s been wild. Back in February, we had a thing called medics’ day, when we get our medical advisers together with our core writers. It’s so valuable, because we get a real insight on what emergency departments are like around the country, and what the big challenges are. Obviously, we all knew about coronavirus in Italy, and somebody asked them, “Oh, are you guys ready for coronavirus?” And these nurses, paramedics, and consultants were like: “Well, no. It’s going to be a really big deal. It’s going to be really hard. We’re just getting ready for it now.” That was a time when you still felt like you could sort of be flippant about it, and it felt so abstract.

We stopped production. As the head of the story team, the immediate problem was, what do we do with these scripts that are halfway written, and the things that were planned? They were about to film the end of the [season]. So we had a really big decision to make.

Actually, there was a time period where we all just had to rethink, “Well, what do we do? Do we chuck everything out, and do we start again? Do we play this all through the lens of a pandemic? Or do we just try making the show again, and ignore this thing?” That was a real thing that was talked about at the time. Would the audience have any appetite? If you’re living in lockdown and if, potentially, your family members are getting sick, or you’re getting sick, or you’re very worried, do you actually want to watch your characters deal with this, week after week? Or do you want escapism? I think drama does both. Drama reflects what we live in, and drama offers an escape from it. It really felt like we were in a crucible between those two things.

In the end, we decided that we just had to address it, that it was impossible not to. We came up with the idea of having a special, which is the episode that we’re returning with when we’re back on air. It goes from people getting news reports about Italy, up until maybe June or July of this year. It takes us through it with the characters that we love. I was watching bits of it the other day, and I realized I’d forgotten loads of stuff about the early months of the pandemic. It’s brilliantly written, and our cast has done a phenomenal job. So that’s what we’re going to come back with.

But our consensus—and I think we’re right to do this—is that you don’t want COVID stories every week. We’ll have addressed it in this really heart-wrenching way, and then we want to show the emergency department as a place where COVID is something that is being dealt with. People are coming in needing treatment. Medics are having to change the way they work in terms of masks, and all of this kind of stuff. But we will try to tell the huge range of Casualty stories that we were telling before. And I stand by that, because what was so hard was trying to guess back in March how people would feel in January of next year. You don’t really realize how much you rely on the future being like the present.

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